Background and Objectives: This application's broad long-term objective is to improve the delivery of health care in the United States. This specific research focuses on care coordination for patients within primary care settings. The current U.S. health care system is complex, confusing, and fragmented, and coordinating the care of patients is paramount to ensure patient safety and achieve high quality cost-effective health care. Many organizations that are participating in Patient-Centered Medical Home (PCMH) demonstration projects are experimenting with the use of a dedicated care coordinator to help eliminate gaps in shared information and communication among providers and between providers and patients. While these and other care coordination projects individually assessed improvements in health care and health outcomes, analysis of care coordinators'processes are lacking. The purpose of this study is to explore how the new role of care coordinator manifests within primary care practices. Specific Aims: 1: Describe responsibilities and activities associated with the role of care coordinators in primary care practices from their perspectives;2: Examine mechanisms as identified by care coordinators that support information processing for care coordination;3: Examine perspectives of care coordinators regarding how their activities are integrated within practice-wide care processes;4: Describe barriers and facilitators to performing activities associated with care coordination as experienced by care coordinators in primary care practices. Methods: An online wiki will be pilot-tested to create a 4- month discussion forum in which researchers and subjects interactively collect and analyze qualitative data in real- time. This new research methodology will elicit perspectives of 20 purposively sampled care coordinators from primary care settings nationwide. The wiki enables coordinators to interact and learn from each other. The wiki will also be used to conduct real-time qualitative analyses as part of an iterative process. Transparent, online, and participatory analyses will be performed, in which coordinators are also involved in determining the significance of findings. Real-time monitoring of online dialogue can be conducted, and preliminary findings will be shared with coordinators, allowing them to help build on or clarify emerging concepts. Probing questions can be used by both coordinators and the research team to gain better understanding of key concepts and to help clarify, elaborate and reflect on the ongoing dialogue. Outcomes: This will give a baseline assessment of how this new role of care coordinator manifests in primary care practices and how coordination processes can be improved. Significance: This will lead to a future study testing the effectiveness of this collaborative learning environment in improving the role of care coordinators and for evaluating the feasibility, transferability, and sustainability of integrating care coordinators into primary care settings. This new research methodology may also be translated to other health services research, enabling qualitative research to be conducted quicker and cheaper, and helping to transform health services research into the fast growing cyber age. PUBLIC HEALTH RELEVANCE: The current U.S. health care system is complex, confusing, and fragmented, and coordinating the care of patients is paramount to ensure patient safety and achieve high quality cost-effective health care. How best to accomplish coordination of care remains unclear. This project will pilot the use of an online wiki to explore how the new role of care coordinator manifests within primary care practices and how care-coordination processes can be improved.